Maximizes reimbursement for both patient and hospital through cooperation with third party payers and physicians. Follows up on denials based on resource utilization issues. Provides a smooth transition for the patient from hospital to home or alternative care setting through coordination of services to meet the post discharge needs identified while maintaining a balance among quality outcome, cost, and process. Identifies those patients with significant psychosocial needs and makes referrals to Social Services. Promotes continuous quality improvement by monitoring team processes as well as through communication with other teams impacted by or impacting the processes of this team.
Must be proficient in case management with at least 2 years experience. Requirements are 1 weekend per month.